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TECHNICAL DOCUMENT         Core competencies for           infection control andhospital hygiene professionals         in ...
ECDC TECHNICAL DOCUMENTCore competencies for infection controland hospital hygiene professionalsin the European Union
AcknowledgementsMany individuals and institutions contributed to this list of core competencies.Firstly, we would like to ...
TECHNICAL DOCUMENT                     Core competencies for infection control and hospital hygiene professionals in the E...
Core competencies for infection control and hospital hygiene professionals in the European Union   TECHNICAL DOCUMENTAbbre...
TECHNICAL DOCUMENT              Core competencies for infection control and hospital hygiene professionals in the European...
Core competencies for infection control and hospital hygiene professionals in the European Union   TECHNICAL DOCUMENTDefin...
TECHNICAL DOCUMENT          Core competencies for infection control and hospital hygiene professionals in the European Uni...
Core competencies for infection control and hospital hygiene professionals in the European Union   TECHNICAL DOCUMENTAppen...
TECHNICAL DOCUMENT          Core competencies for infection control and hospital hygiene professionals in the European Uni...
Core competencies for infection control and hospital hygiene professionals in the European Union            TECHNICAL DOCU...
TECHNICAL DOCUMENT          Core competencies for infection control and hospital hygiene professionals in the European Uni...
Core competencies for infection control and hospital hygiene professionals in the European Union        TECHNICAL DOCUMENT...
TECHNICAL DOCUMENT          Core competencies for infection control and hospital hygiene professionals in the European Uni...
Core competencies for infection control and hospital hygiene professionals in the European Union        TECHNICAL DOCUMENT...
TECHNICAL DOCUMENT        Core competencies for infection control and hospital hygiene professionals in the European Union...
Core competencies for infection control and hospital hygiene professionals in the European Union        TECHNICAL DOCUMENT...
TECHNICAL DOCUMENT        Core competencies for infection control and hospital hygiene professionals in the European Union...
Core competencies for infection control and hospital hygiene professionals in the European Union      TECHNICAL DOCUMENTDo...
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Infection control-core-competencies

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Publicación del ECDC sobre las competencias en control de infecciones

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  1. 1. TECHNICAL DOCUMENT Core competencies for infection control andhospital hygiene professionals in the European Union www.ecdc.europa.eu
  2. 2. ECDC TECHNICAL DOCUMENTCore competencies for infection controland hospital hygiene professionalsin the European Union
  3. 3. AcknowledgementsMany individuals and institutions contributed to this list of core competencies.Firstly, we would like to acknowledge the contribution of the Training in Infection Control in Europe (TRICE) project1 led by SilvioBrusaferro (University of Udine, Italy) with the participation of a consortium of European experts:Barry Cookson (United Kingdom), Tracey Cooper (United Kingdom), Jacques Fabry (France), Rose Gallagher (United Kingdom),Philippe Hartemann (France), Smilja Kalenić (Croatia), Kerstin Mannerquist (Sweden), Walter Popp (Germany), Gaetano Privitiera(Italy)and Pierluigi Viale (Italy), and Christian Rueff who represented the European Society of Clinical Microbiology and InfectiousDiseases (ESCMID), as well as thank the supporting staff of the project: Elisa Fabbro and Francesco Coiz.Secondly, we would like to acknowledge the important contribution of the National Contact Points for Infection Control Training(NCPICTs) who, after nomination by their country, participated in the project, some attended the meeting of June 2010 in Udineand later reviewed the draft list of core competencies:Austria: Helmut Mittermayer2 (Krankenhaus der Elisabethinen, Linz); substitute for Austria: Alexander Blacky (Klinisches Institutfür Krankenhaushygiene, Medizinische Universität Wien); Belgium: Anne Simon (Université Catholique de Louvain); Bulgaria:Rossitza Vatcheva-Dobrevska (National Centre of Infectious and Parasitic Diseases, Sofia); Cyprus: Michael Stavroulla (Ministry ofHealth, Nicosia); Czech Republic: Dana Hedlova (Central Military Hospital, Prague) and Jan Šturma (Central Military Hospital,Prague); Denmark: Jette Holt (Statens Serum Institut, Copenhagen); Estonia: Annika Lemetsar (Health Board, Tallinn); Finland:Outi Lyytikäinen (National Institute for Health and Welfare, Helsinki); France: Pascal Astagneau (CCLIN Paris-Nord, Paris);Germany: Martin Mielke (Robert Koch-Institut, Berlin); Greece: Lemonia Ftika (Hellenic Center for Disease Control and Prevention,Athens); Hungary: Ágnes Hajdú (National Center for Epidemiology, Budapest); Ireland: Sheila Donlon (Health ProtectionSurveillance Centre, Dublin); Italy: Maria Luisa Moro (Regional Health Agency, Emilia-Romagna) and Davide Resi (Regional HealthAgency, Emilia-Romagna); Latvia: Raina Nikiforova (State Agency ‘Infectology Centre of Latvia’, Riga); Lithuania: Greta Gailiene(Institute of Hygiene, Vilnius); Luxembourg: Elisabeth Heisbourg (Direction de la santé, Luxembourg); Malta: Michael Borg(Health Department of Malta, Valletta); Netherlands: Birgit van Benthem (National Institute for Public Health and theEnvironment, Bilthoven) and Leo Ummels (Radboud University Nijmegen Medical Centre, Nijmegen); Norway: Nina Sorknes(Norwegian Institute of Public Health, Oslo); Poland: Pawel Stefanoff (National Institute of Public Health, Warsaw); Portugal:Cristina Costa (Directotate General of Health, Lisbon); Romania: Daniela Pitigoi (National Institute for Infectious Diseases ‘MateiBals’, Bucharest); Slovakia: Zuzana Krištůfková (Faculty of Public Health, Bratislava); Slovenia: Jana Kolman (National Institute ofPublic Health, Ljubljana); Spain: Antonio Pareja Bezares (Hospital Son Llàtzer, Palma de Mallorca); Sweden: Kerstin Mannerquist(Swedish Institute for Communicable Disease Control, Stockholm); United Kingdom: Elizabeth Sheridan (Health ProtectionAgency, London); Croatia: Ana Budimir (University Clinical Center, Zagreb); Turkey: Yeşim Çetinkaya Şardan (Medicine Faculty ofHacettepe University, Ankara).Four representatives from the United Kingdom contributed to the review of the draft list of core competencies:Elisabeth Sheridan (England), Anne Mills (Northern Ireland), Carol Fraser (Scotland), and Tracey Gauci (Wales).Thirdly, we would like to acknowledge the initial contribution of members of the pedagogic committee of work package 1 of theImproving Patient Safety in Europe project (IPSE) who developed a first version of this list of competencies for infection controland hospital hygiene professionals in Europe: Jacques Fabry, Josette Najjar-Pellet (Claude-Bernard University Lyon 1, France),Benedetta Allegranzi (WHO, Geneva), Dilek Arman (Turkish Society of Hospital Infection and Control, Ankara, Turkey), BarryCookson (Health Protection Agency, London, United Kingdom), Jette Holt (Statens Serum Institute, Copenhagen, Denmark), NinaSorknes (Norwegian Institute of Public Health, Oslo, Norway) Christian Rueff (University Hospital Zurich, Zurich, Switzerland) andAndreas Voss (Radboud University, Nijmegen, Netherlands). Christian Rueff and Andreas Voss also represented the EuropeanSociety of Clinical Microbiology and Infectious Diseases (ESCMID) on the committee.Finally, the following ECDC staff members were involved: Carl Suetens (content lead), senior expert, healthcare-associatedinfections, ARHAI Programme; Carmen Varela Santos (project management and learning methodological aspects), senior expert,Public Health Training Section; Vladimir Prikazsky, expert, Public Health Training Section, ARHAI Programme; Arnold Bosman,Head, Public Health Training Section; Marc Struelens, chief microbiologist; and Dominique Monnet, head, ARHAI Programme.Suggested citation: European Centre for Disease Prevention and Control. Core competencies for infection controland hospital hygiene professionals in the European Union. Stockholm: ECDC; 2013.Stockholm, March 2013ISBN 978-92-9193-448-5doi 10.2900/7778Catalogue number TQ-30-13-346-EN-CCover photograph: (cc) Ralf Heß© European Centre for Disease Prevention and Control, 2013Reproduction is authorised, provided the source is acknowledged1 The Training in Infection Control in Europe (TRICE) project was funded by ECDC through a specific service contract (ECD.1840)to the University of Udine, Italy.2 In memory of Professor Helmut Mittermayer.ii
  4. 4. TECHNICAL DOCUMENT Core competencies for infection control and hospital hygiene professionals in the European UnionContentsAbbreviations ............................................................................................................................................... ivBackground ................................................................................................................................................... 1Development process ..................................................................................................................................... 1Definitions of competency and of core competency ........................................................................................... 2Use and users................................................................................................................................................ 2List of core competencies ............................................................................................................................... 3Appendix. List of core competencies for infection control and hospital hygiene professionals in the European Union,grouped by areas and domains ....................................................................................................................... 4TablesTable A1. Areas and domains of competency in infection control and hospital hygiene ......................................... 4Table A2. Areas, domains and competencies in infection control and hospital hygiene for junior and seniorspecialists (introductory and expert levels) ....................................................................................................... 5 Area 1. Programme management ..................................................................................................... 5 Area 2. Quality improvement ............................................................................................................ 8 Area 3. Surveillance and investigation of healthcare-associated infections .......................................... 10 Area 4. Infection control activities ................................................................................................... 12 iii
  5. 5. Core competencies for infection control and hospital hygiene professionals in the European Union TECHNICAL DOCUMENTAbbreviationsAMR Antimicrobial resistanceARHAI Antimicrobial resistance and healthcare-associated infectionsECDC European Centre for Disease Prevention and ControlESCMID European Society of Clinical Microbiology and Infectious DiseasesEU European UnionHAI Healthcare-associated infectionHCW Healthcare workerIPSE Improving Patient Safety in Europe projectiv
  6. 6. TECHNICAL DOCUMENT Core competencies for infection control and hospital hygiene professionals in the European UnionBackgroundHealthcare-associated infections are recognised as a major burden for patients, society and healthcaremanagement. In 2008, ECDC estimated that more than four million people acquire a healthcare-associatedinfection each year in the European Union (EU), of which approximately 37 000 die as the direct consequence ofthe infection3.One major topic that falls under the mandate of the European Centre for Disease Prevention and Control (ECDC) isthe strengthening of the European Union’s capacity for the prevention and control of infectious diseases4 as well asa number of special health issues listed under Decision 2119/98 EC5, which include healthcare-associated infections(HAI). The Centre also has a role in strengthening capacity by assisting the Member States and the Commission inobtaining sufficient numbers of trained specialists.Effective HAI prevention and control in healthcare organisations relies on specialised infection control staff incharge of elaborating, implementing and monitoring local preventive measures such as hand hygiene and patientisolation.Increased efforts in this area are backed by a 2008 ‘Communication from the Commission to the EuropeanParliament and the Council on patient safety, including the prevention and control of healthcare-associatedinfections’6,7.Training in infection control and the epidemiology of healthcare-associated infections was also the topic of one ofthe work packages of the Improving Patient Safety in Europe project (IPSE), the now-defunct EU surveillancenetwork for healthcare-associated infections.Development processIn collaboration with the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), IPSEdeveloped a first document on core competencies for infection control nurses and physicians in Europe8,9. ECDCdrew upon previous IPSE experiences to assess the training needs for infection control in Europe (through acontract with the University of Udine10, Italy), with the goal of developing a basic training strategy at the EU levelin the area of infection control.This document results from a multi-staged process of reviews, discussions and updates of a previous list of corecompetencies for infection control and hospital hygiene. This was done through meetings between EDCDC and theproject core team and the National Contact Points for Infection Control Training (NCPICTs) (as proposed by the EUMember States) and a June 2010 meeting in Udine, Italy, which was also attended by representatives from Croatiaand Turkey and followed-up by e-mail consultations. During these meetings, statements were proposed,commented, amended or changed; the resulting text version was eventually verified and agreed upon by theNCPICTs. Finally, the NCPICTs were requested to approve the proposed two-tier classification (introductory leveland expert level) in infection control and hospital hygiene, which had been discussed earlier during the meeting.3 European Centre for Disease Prevention and Control (ECDC). Annual epidemiological report on communicable diseases inEurope 2008. Stockholm: ECDC; 2008. Available from:http://ecdc.europa.eu/en/publications/Publications/0812_SUR_Annual_Epidemiological_Report_2008.pdf4 Regulation (EC) No 851/2004 of the European Parliament and of the Council of 21 April 2004 establishing a European Centre forDisease Prevention and Control. Available from: http://www.ecdc.europa.eu/About_us/Key_Documents/ecdc_regulations.pdf5 Decision No 2119/98/EC of the European Parliament and of the Council of 24 September 1998 setting up a network for theepidemiological surveillance and control of communicable diseases in the Community.6 http://ec.europa.eu/health/ph_systems/docs/patient_com2008_en.pdf7 Council of the European Union. Council Recommendation of 9 June 2009 on patient safety, including the prevention and controlof healthcare associated infections (2009/C 151/01). Available from: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:C:2009:151:0001:0006:EN:PDF8 Improving Patient Safety in Europe (IPSE). The IPSE report 2005-2008. Lyon: Université Claude Bernard Lyon 1; November2009]. Available from:http://www.ecdc.europa.eu/en/activities/surveillance/HAI/Documents/0811_IPSE_Technical_Implementation_Report.pdf9 http://ecdc.europa.eu/ipse/Working%20packages/WP1/Core%20Curriculum%20Report.pdf10 The Training in Infection Control in Europe (TRICE) project was funded by ECDC through a specific service contract (ECD.1840)with the University of Udine, Italy. 1
  7. 7. Core competencies for infection control and hospital hygiene professionals in the European Union TECHNICAL DOCUMENTDefinitions of competency and of corecompetencyIn Europe, a variety of terms relating to ‘competencies’ is used, each fraught with different meanings and linked tosomewhat different frames of reference. All definitions, however, are related to what the individual will know,understand and be able to do at the end of a learning experience.In the context of the European Qualifications Framework, competence is described in terms of responsibility andautonomy.In this document, the term competency is defined as: ‘the proven ability to use knowledge, skills and personal,social and/or methodological abilities, in work or study situations and in professional and personal development’11.The core competencies listed in this document are defined for infection control and hospital hygieneprofessionals, with the profile of a medical doctor, nurse or caregiver. The term ‘core’ indicates that thecompetencies should be a minimum pre-requisite, common to all professionals in this field.In the list, core competencies are classified in areas and domains, and proposed separately for the introductorylevel and for the expert level. The levels are defined as follows: Introductory level (junior specialist): newly appointed infection control and hospital hygiene staff member with little or no previous experience. Expert level (senior specialist): infection control and hospital hygiene professionals who are confident and experienced; who use reasoning, critical thinking, reflection and analysis to inform his/her assessment and decision-making; and are able to develop and implement new solutions to problems.It is acknowledged that professional expertise grows in a continuum where speed of acquisition and completenessof knowledge depend on many different variables such as local culture (e.g. expectations that the infection controldoctor or infection control nurse will chair the infection control committee), the existence of a professional profilefor infection control/hospital hygiene professionals in a given country, the level of administrative support orresources, the presence of audit/patient safety departments, attitudes, preferences, and previous experience (e.g.when newly hired infection control doctors or nurses already have considerable managementexperience/transferable skills in other specialties before embarking on their new infection control and hospitalhygiene career).Use and usersThis list of core competencies is not a regulatory document or part of a curriculum, but rather a reference paperfor different groups of users and a variety of uses.This document is published with the intent of proposing a comprehensive list of core competencies that should beadopted by infection control and hospital hygiene professionals across Europe.This document can be considered as a reference for the: standardisation of the competencies for infection control and hospital hygiene professionals in Europe; design and implementation of training courses according to different national contexts while facilitating the mutual recognition of competencies across the EU Member States; self-assessment of performance for infection control and hospital hygiene professionals and the planning of professional development; identification of the needs of healthcare organisations with regard to professional staff; and the evaluation of the performance of infection control and hospital hygiene professionals.The use of this list of core competencies as a reference could increase the comparability of job descriptions andfacilitate the mobility of professionals throughout Europe. The core competencies could be used as a basis forcertain human resource tools, such as annual performance reviews or personal development plans, by selectingfour to six competencies as goals for infection control and hospital hygiene professionals.Potential users are public health institutes, universities, hospitals and other healthcare organisations, trainingprogrammes, professionals and trainees.11 http://ec.europa.eu/education/policies/educ/eqf/rec08_en.pdf2
  8. 8. TECHNICAL DOCUMENT Core competencies for infection control and hospital hygiene professionals in the European UnionList of core competenciesThe list of core competencies for infection control and hospital hygiene professionals in the European Union,grouped by areas and domains, is presented in the Appendix.ECDC plans to use this list as an assessment tool for specific training needs in the EU Member States (e.g. duringcountry visits or for surveys). 3
  9. 9. Core competencies for infection control and hospital hygiene professionals in the European Union TECHNICAL DOCUMENTAppendix. List of core competencies forinfection control and hospital hygieneprofessionals in the European Union, groupedby areas and domainsTable A1. Areas and domains of competency in infection control and hospital hygieneArea DomainArea 1. Programme management Elaborating and advocating an infection control programme Management of an infection control programme, work plan and projectsArea 2. Quality improvement Contributing to quality management Contributing to risk management Performing audits of professional practices and evaluating performance Infection control training of employees Contributing to researchArea 3. Surveillance and Designing a surveillance systeminvestigation of healthcare- Managing (implementation, follow up, evaluation) a surveillance systemassociated infections (HAIs) Identifying, investigating and managing outbreaksArea 4. Infection control Elaborating infection control interventionsactivities Implementing infection control healthcare procedures Contributing to reducing antimicrobial resistance Advising appropriate laboratory testing and use of laboratory data Decontamination and sterilisation of medical devices Controlling environmental sources of infections4
  10. 10. TECHNICAL DOCUMENT Core competencies for infection control and hospital hygiene professionals in the European UnionTable A2. Areas, domains and competencies in infection control and hospital hygiene for junior andsenior specialists (introductory and expert levels)Area 1. Programme managementDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert levelElaborating and Advocate the importance of healthcare- Advocate the importance of healthcare-advocating an associated infections (HAIs) as a crucial associated infections (HAIs) as a crucialinfection control element of patient safety and highlight element of patient safety and highlightprogramme their potential human, economic and their potential human, economic and reputational burden to the decision-makers reputational burden to the decision-makers of the healthcare organisation of the healthcare organisation Contribute to the development of the Prepare and present an outline of an infection control programme infection control programme focusing on key elements: mission statement, Contribute in involving identified description of objectives and indicators, stakeholders in the infection control presentation of action plan, including programme outcomes, success measures, rules for the Identify needs for the protection of functioning of the infection control healthcare workers in their respective committee, operating manual, links to healthcare organisations other patient safety and healthcare organisation programmes Take a lead role as appropriate for the healthcare organisation to formulate, Identify and communicate the propose and liaise with other key players to requirements of an infection control produce appropriate indicators in relation programme to relevant internal and to the control of healthcare-associated external stakeholders (including patient infections, taking into account the official advocates) and develop strategies for policy on internal transfer of information involving them in the infection control and public health disclosure of information programme Foster and promote team work in infection Establish priorities for infection control control according to the characteristics of an individual healthcare organisation, Lead the team to ensure that it has shared including the safety of healthcare workers vision and works cohesively internal transfer of information and public disclosure of information, respecting ethical standards for patient protection Take a lead role as appropriate for the healthcare organisation to formulate, propose and liaise with other key players to produce appropriate indicators in relation to the control of healthcare-associated infections, taking into account the official policy on internal transfer of information and public health disclosure of information Foster and promote team work in infection control Lead the team to ensure that it has shared vision and works cohesivelyManagement of Contribute to the management of an Manage an infection control programme oran infection infection control programme or other other programmes on adverse eventscontrol programmes on adverse events (from (from conception to impact evaluation,programme, conception to impact evaluation, including including budgeting) according to EU,work plan and budgeting) according to EU, national or national or local regulations and healthcareprojects local regulations and healthcare organisation policies organisation policies Play a key role in formulating an Participate in the formulation of an organisational structure for controlling HAIs organisational structure for controlling HAIs and antimicrobial resistance (AMR) in the healthcare organisation – while interacting Collate data regarding the infrastructure in 5
  11. 11. Core competencies for infection control and hospital hygiene professionals in the European Union TECHNICAL DOCUMENTDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert level the healthcare organisation in order to with others as appropriate review and recommend appropriate Review, assess, provide and recommend resources for HAI control appropriate resources for infection control Be able to manage system changes related in the healthcare organisation: scientific to infection control issues based on and technical expertise, facilities for knowledge of the healthcare organisation infection control, information systems, continuing education, use of link Be able to manage individual and professionals12, allocated budget organisational changes utilising knowledge of the behavioural sciences Be able to manage system changes related to infection control issues based on Identify financial resources with cost– knowledge of the health organisation benefit analyses of infection control activities and learn negotiation skills Be able to manage individual and organisational changes utilising knowledge Attend infection control committee of the behavioural sciences meetings and contribute to the agenda and agreed actions, and keep minutes of Identify and negotiate financial resources infection control committee meetings with cost–benefit analyses of infection control activities Contribute to the regular review of policies/procedures for HAI prevention and Organise and support the meetings of an control infection control committee and technical working groups Support ways to improve team work: provide tools for the sharing of Organise and lead regular reviews of responsibilities, the exchange of policies/procedures in collaboration with information, and the planning of tasks multidisciplinary experts Participate in providing specialist expertise Support ways to improve team work: related to infection control on healthcare provide tools for the sharing of organisation policies and know where to responsibilities, the exchange of access this expertise if it is not available information, and the planning of tasks locally Provide specialist expertise related to Disseminate information regarding infection control on healthcare organisation legislation, regulations and official policies recommendations for infection control Formulate and facilitate a suitable strategy Inform healthcare workers (HCWs) about for internal communications on infection new threats: epidemics, new agents, etc. control with key stakeholders Communicate with, and provide support to, Disseminate information regarding the healthcare organisation’s contractors legislation, regulations and official and service providers (construction, recommendations for infection control renovation, maintenance, housekeeping, Inform healthcare workers (HCWs) about laundry, etc.) new threats: epidemics, new agents, etc. Appropriately report infection control Communicate with, and provide support to, findings to the infection control committee, the healthcare organisation’s contractors the healthcare organisation’s management, and service providers (construction, clinical departments, units and involved renovation, maintenance, housekeeping, professionals laundry, etc.) Improve communication between different Appropriately report infection control levels of care (primary, hospital, long term) findings to the infection control committee, Promote collaborative partnerships the healthcare organisation’s management, between professionals clinical departments, units and involved professionals Contribute appropriately to external communications on infection control, Improve communication between different12 ‘Link professionals (mostly nurses) act as a link between their own clinical area and the infection control team. Their role is toincrease awareness of infection control issues in their ward and motivate staff to improve practice.’ From: Dawson SJ. The role ofthe infection control link nurse. J Hosp Infect. 2003 Aug;54(4):251-7.6
  12. 12. TECHNICAL DOCUMENT Core competencies for infection control and hospital hygiene professionals in the European UnionDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert level including communications with public levels of care (primary, hospital, long term) health authorities as and when required Promote collaborative partnerships Communicate with the media if agreed between professionals locally Contribute appropriately to external Contribute to the review and evaluation of communications on infection control, an infection control programme including communications with public health authorities as and when required Communicate with the media if agreed locally Review and evaluate infection control programmes regularly, according to updated legislation, recommendations and latest feedback (audits, surveillance results, etc.) 7
  13. 13. Core competencies for infection control and hospital hygiene professionals in the European Union TECHNICAL DOCUMENTArea 2. Quality improvementDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert levelContributing to Contribute to the ongoing accreditation, Contribute to the ongoing accreditation,quality certification, evaluation and normalisation certification, evaluation and normalisationmanagement processes within the healthcare processes within the healthcare organisation organisation Contribute to the integration of infection Contribute to the integration of infection control activities within the healthcare control activities within the healthcare organisation’s quality promotion and organisation’s quality promotion and patient safety programmes patient safety programmes Prepare, conduct and coordinate audits of Prepare, conduct and coordinate audits of professional practices related to infection professional practices related to infection control in clinical areas control in clinical areas Collaborate with HCWs, patients and their Lead (where appropriate) and support relatives in evaluating the infection control other stakeholders, e.g. HCWs, consumers aspects of quality and patient safety and consumer groups to establish and programmes evaluate the infection control aspects of quality and patient safety programmesContributing to Advocate and enable integration of risk Advocate and enable integration of riskrisk management concepts (such as rapid management concepts (such as rapidmanagement reporting of adverse events or errors, reporting of adverse events or errors, without sanctions) and methods (such as without sanctions) and methods (such as systemic analysis, e.g. root causes of systemic analysis, e.g. root causes of adverse events) in infection control adverse events) in infection control activities within the healthcare organisation activities within the healthcare organisation Contribute – if locally appropriate – to the Contribute – if locally appropriate – to the ongoing risk management programme of ongoing risk management programme of the healthcare organisation by coordinating the healthcare organisation by coordinating infection control activities with other safety infection control activities with other safety programmes such as for transfusion, programmes such as for transfusion, administration of drugs, or use of medical administration of drugs, or use of medical devices (coordinated communication, devices (coordinated communication, training, data collection or notification, training, data collection or notification, etc.) etc.)Performing Take into account the different clinical and Take into account the different clinical andaudits of cultural considerations and conditions that cultural considerations and conditions thatprofessional determine the various types of evaluations determine the various types of evaluationspractices and and audits and auditsevaluating Establish a programme of audits and Establish a programme of audits andperformance investigations investigations Prepare protocols for the evaluation of Prepare protocols for the evaluation of performance performance Train investigators so they can assess Train investigators so they can assess targeted practices, structures or processes targeted practices, structures or processes Apply appropriate epidemiological methods Apply appropriate epidemiological methods during data collection to ensure reliability during data collection to ensure reliability and reproducibility and reproducibility Analyse data and interpret results related Analyse data and interpret results related to the evaluation and report back to to the evaluation and report back to relevant staff in appropriate language relevant staff in appropriate language Coordinate, and report on, the progress of Coordinate, and report on, the progress of the audits programme and associated the audits programme and associated learning in the targeted units or learning in the targeted units or departments departments8
  14. 14. TECHNICAL DOCUMENT Core competencies for infection control and hospital hygiene professionals in the European UnionDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert level Disseminate and communicate Disseminate and communicate constructively the results of audits and the constructively the results of audits and the lessons learnt to the HCWs, administration lessons learnt to the HCWs, administration and other professionals involved and other professionals involved Work with the healthcare organisation to Work with the healthcare organisation to formulate corrective actions and enable formulate corrective actions and enable staff to carry out these actions to ensure staff to carry out these actions to ensure that evaluation results are acted upon that evaluation results are acted uponInfection control Evaluate the training needs of the Evaluate the training needs of thetraining of healthcare organisation and of HCWs healthcare organisation and of HCWsemployees through consultations and surveys and through consultations and surveys and other methodologies such as gap analysis other methodologies such as gap analysis Integrate within the healthcare Integrate within the healthcare organisation’s training programme for new organisation’s training programme for new employees, basic knowledge and employees, basic knowledge and awareness of infection control issues awareness of infection control issues Design a training programme on infection Design a training programme on infection control activities and procedures for all control activities and procedures for all employees in healthcare organisation to employees in the healthcare organisation update their knowledge and awareness to update their knowledge and awareness according to the latest data (national, local, according to the latest data (national, local, newly published) newly published) Select and provide appropriate training Select and provide appropriate training modalities to achieve expected outcomes modalities to achieve expected outcomes Evaluate the impact of the training sessions Evaluate the impact of the training sessionsContributing to Understand the methodology of evaluative Understand the methodology of evaluativeresearch and research studies [descriptive or and research studies [descriptive or analytic studies (cohort, case-control), analytic studies (cohort, case-control), randomised trial, efficacy or cost- randomised trial, efficacy or cost- effectiveness of intervention or technology, effectiveness of intervention or technology, and meta-analysis], and interpret and use and meta-analysis], and interpret and use the results the results Contribute to the research by collecting Apply standard methodologies of research data according to the surveillance design to the investigation of healthcare- and defined methodology associated infections and to the evaluation of preventive measures 9
  15. 15. Core competencies for infection control and hospital hygiene professionals in the European Union TECHNICAL DOCUMENTArea 3. Surveillance and investigation of healthcare-associated infectionsDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert levelDesigning a Advocate HAI surveillance activities Advocate HAI surveillance activitiessurveillance (including post-discharge surveillance) (including post-discharge surveillance)system and gather the opinions of appropriate and gather the opinions of appropriate professionals in order to rank priorities professionals in order to rank priorities and formulate objectives and formulate objectives Formulate the scope, methodology and Formulate the scope, methodology and practical organisation of the HAI practical organisation of the HAI surveillance system based on the surveillance system based on the population served, services provided and population served, services provided and professional involvement in order to meet professional involvement in order to meet the objectives the objectives Select and define appropriate indicators Select and define appropriate indicators Gather specific data from the laboratory Develop functional links with the and pharmacy departments for further laboratory and pharmacy departments for analysis periodically reviewing laboratory and antimicrobial consumption data Identify national and international recommendations, regulations and Identify national and international standard definitions to design HAI recommendations, regulations and surveillance activities, ensuring all the standard definitions to design HAI while the need for consistency in applying surveillance activities, ensuring all the definitions while the need for consistency in applying definitions Support the development of the healthcare organisation’s information Support the development of the systems (including patient and laboratory healthcare organisation’s information systems) to meet surveillance needs systems (including patient and laboratory systems) to meet surveillance needs Contribute to the organisation of collaborative organised networks Identify the benefits of collaborative organised networks (local, regional and Elaborate mechanisms for timely data national) and take steps to promote these feedback and ensure that prompt and networks responsive mechanisms for reporting and feedback are included in the system Elaborate mechanisms for timely data feedback and ensure that prompt and responsive mechanisms for reporting and feedback are included in the systemManaging Contribute to the implementation of HAI Implement the HAI surveillance system(implementation, surveillance system (pilot testing, implementation, kick off,follow up, commissioning and evaluation) according Design and develop systems for effectiveevaluation) a to the organisation’s priorities and HAI data collection according to definedsurveillance objectives methodologysystem Design and develop systems for effective Participate in preparation of HAI HAI data collection according to defined surveillance data for analysis methodology Identify, and communicate with, the Analyse HAI data using appropriate healthcare organisation or public health epidemiological methods, measures and body if additional epidemiologic tests, seeking the assistance of investigations (case-control studies, biostatisticians and other experts when cohort studies, trials) and outbreak necessary investigations are required Identify, and communicate with, the Contribute to the production of periodic healthcare organisation or public health structured reports of surveillance data body if additional epidemiologic Regularly review the risks, needs and investigations (case-control studies, priorities in order to adjust surveillance cohort studies, trials) and outbreak targets and objectives investigations are required10
  16. 16. TECHNICAL DOCUMENT Core competencies for infection control and hospital hygiene professionals in the European UnionDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert level Prepare data for the periodic evaluation of Produce periodic structured reports to the effectiveness of the HAI surveillance interpret significant findings and learning, system taking into account the target readership Ensure that reporting and feedback tools Regularly review the risks, needs and are efficiently used to communicate priorities in order to adjust surveillance adequately in different contexts (scientific, targets and objectives professional, media, etc.) Periodically evaluate the effectiveness of Use feedback tools effectively the HAI surveillance system Ensure that reporting and feedback tools are efficiently used to communicate adequately in different contexts (scientific, professional, media, etc.) Use feedback tools effectivelyIdentifying, Identify clusters of HAIs (or other unusual Identify clusters of HAIs (or other unusualinvestigating and events) through contacts with clinical events) through contacts with clinicalmanaging units and laboratories, through alerts or units and laboratories, through alerts oroutbreaks through systematic analysis of through systematic analysis of microbiological laboratory testing microbiological laboratory testing Manage an outbreak of infections at Manage an outbreak of infections at healthcare organisation or community healthcare organisation or community level level Carry out descriptive and analytic Carry out descriptive and analytic investigations of the outbreak investigations of the outbreak Select appropriate methods of molecular Select appropriate methods of molecular typing and interpret microbiological typing and interpret microbiological results in close collaboration with results in close collaboration with clinical/reference microbiology clinical/reference microbiology laboratories laboratories Formulate and implement a suitable Formulate and implement a suitable strategy for identifying and strategy for identifying and communicating internally and externally communicating internally and externally with concerned actors, including those in with concerned actors, including those in primary, hospital and long-term care primary, hospital and long-term care Interpret findings and report them to Interpret findings and report them to relevant people by using appropriate relevant people by using appropriate means and seek the relevant internal and means and seek the relevant internal and external personnel advice, including external personnel advice, including advice from the public health sector advice from the public health sector Use lessons learned from outbreak Use lessons learned from outbreak investigations to inform quality investigations to inform quality improvement measures improvement measures 11
  17. 17. Core competencies for infection control and hospital hygiene professionals in the European Union TECHNICAL DOCUMENTArea 4. Infection control activitiesDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert levelElaborating Collect and analyse the relevant Collect and analyse the relevantinfection control documentation for the development of an documentation for the development of aninterventions infection control procedure infection control procedure Prepare infection control policies and Prepare infection control policies and procedures according to national or local procedures according to national or local standard operating procedures (SOPs), for standard operating procedures (SOPs), for example for validated main infection example for validated main infection control activities, i.e. standard precautions control activities, i.e. standard precautions and hand hygiene and hand hygiene Isolation and special (barrier) precautions Isolation and special (barrier) precautions Skin disinfection Skin disinfection Patient pre-operative preparation Patient pre-operative preparation Decontamination and sterilisation of Decontamination and sterilisation of medical devices medical devices Invasive procedures: vascular and urinary Invasive procedures: vascular and urinary catheterisation, mechanical ventilation, catheterisation, mechanical ventilation, etc. etc. Support activities: linen and waste Support activities: linen and waste management, housekeeping, food service, management, housekeeping, food service, environmental safety (air, water), environmental safety (air, water), decontamination of environmental decontamination of environmental surfaces surfaces Examples for occupational health Examples for occupational health activities: management following fluid activities: management following fluid exposure, prevention of inoculation exposure, prevention of inoculation injuries and other infection risks in HCWs injuries and other infection risks in HCWs Immunisation of HCWs and patients Immunisation of HCWs and patients Contribute to the design and Prepare a procedure for crisis implementation of procedures for crisis management in infection control: alert management in infection control: alert management, recall of patients, recall of management, recall of patients, recall of potentially contaminated equipment and potentially contaminated equipment and supplies, reporting and exchange with supplies, reporting and exchange with relevant healthcare professionals relevant healthcare professionals Contribute to the drawing up of clinical Contribute to the drawing up of clinical procedures when special precautions for procedures when special precautions for infection control are required infection control are required Contribute to the drawing up of clinical Contribute to the drawing up of clinical procedures for specific settings procedures for specific settings Plan strategies for the design of Plan strategies for the design of healthcare procedures healthcare proceduresImplementing Contribute to set a policy for the Set a programme for the implementationinfection control implementation and revision of infection and the revision of infection controlhealthcare control guidelines and recommendations guidelines and recommendationsprocedures according to the SOPs: roles and according to the SOPs: roles and responsibilities of supervisor, trainers, link responsibilities of supervisor, trainers, link professionals professionals Disseminate pertinent policies and Disseminate pertinent policies and procedures to applicable departments and procedures to applicable departments and help HCWs in their implementation help HCWs in their implementation through continuous support. through continuous support.12
  18. 18. TECHNICAL DOCUMENT Core competencies for infection control and hospital hygiene professionals in the European UnionDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert level Identify barriers to compliance with Identify barriers to compliance with procedures and involve HCWs procedures and involve HCWs Promote and participate in the evaluation Promote and participate in the evaluation of compliance to the procedures and of compliance to the procedures and contribute to the improvement of contribute to the improvement of compliance by monitoring parameters compliance by monitoring parameters with regard to process or outcome with regard to process or outcome Facilitate the implementation of infection Facilitate the implementation of infection control procedures within the clinical care control procedures within the clinical care organisation organisationContributing to Promote the importance of prevention Promote the importance of preventionreducing and control of antimicrobial resistance and control of antimicrobial resistanceantimicrobial (AMR), including antibiotic prophylaxis. (AMR), including antibiotic prophylaxis.resistance Highlight the human, economic and wider Highlight the human, economic and wider public health burden of AMR and public health burden of AMR and communicate it to the decision-makers of communicate it to the decision-makers of the healthcare organisation and the the healthcare organisation and the community community Identify the specific local determinants of Identify the specific local determinants of AMR in the healthcare organisation AMR in the healthcare organisation Implement a plan to reduce AMR in the Prepare a plan to reduce AMR in the healthcare organisation, based on findings healthcare organisation, based on findings related to local determinants and focused related to local determinants and focused on decreasing overuse and misuse of on decreasing overuse and misuse of antimicrobial agents and limiting cross- antimicrobial agents and limiting cross- infection and contamination infection and contamination Involve key people in the implementation Identify and involve key people in the of a plan to reduce AMR in the healthcare implementation of a plan to reduce AMR organisation in the healthcare organisation Implement surveillance of AMR in the Implement surveillance of AMR in the healthcare organisation; participate in healthcare organisation; participate in national and international surveillance national and international surveillance schemes. schemes. Formulate and propose appropriate Formulate and propose appropriate indicators concerning the identification indicators concerning the identification and control of AMR, taking into account and control of AMR, taking into account the official policy on internal transfer of the official policy on internal transfer of information information Participate and involve infection control Participate and involve infection control committee members in periodic committee members in periodic evaluations (audits) of antimicrobial usage evaluations (audits) of antimicrobial usage for treatment and prophylaxis for treatment and prophylaxis Contribute to the training of HCWs in Contribute to the training of HCWs in antimicrobial usage, including prescription antimicrobial usage, including prescription practice, dispensing and audit of usage practice, dispensing and audit of usageAdvising Advise about appropriate surveillance and Advise about appropriate surveillance andappropriate screening/testing, including policies for screening/testing, including policies forlaboratory testing patient testing based on microbial habitats patient testing based on microbial habitatsand use of and pathogenesis of infectious diseases and pathogenesis of infectious diseaseslaboratory data Be able to interpret microbiological data Be able to interpret microbiological data to assist in the prevention and control of to assist in the prevention and control of infections infections Understand characteristics of Understand the characteristics of microorganisms and apply knowledge to microorganisms and apply knowledge to 13
  19. 19. Core competencies for infection control and hospital hygiene professionals in the European Union TECHNICAL DOCUMENTDomain Competencies for a junior specialist – Competencies for a senior specialist – introductory level expert level help assess patients and HCW help assess patients and HCW environments in order to estimate the risk environments in order to estimate the risk of transfer of microorganisms of transfer of microorganismsDecontamination Distinguish between levels of risk Distinguish between levels of riskand sterilisation of presented by individuals, equipment and presented by individuals, equipment andmedical devices the environment the environment Propose and select appropriate methods Propose and select appropriate methods and products for decontamination and products for decontamination Develop and update procedures related to Develop and update procedures related to decontamination and sterilisation decontamination and sterilisation guidelines and standards guidelines and standards Support and encourage the centralisation Support and encourage the centralisation of decontamination and sterilisation of of decontamination and sterilisation of medical devices medical devicesControlling Propose appropriate infection control Propose appropriate infection controlenvironmental measures for the management of waste, measures for the management of waste,sources of air, water, laundry and food air, water, laundry and foodinfections Contribute to risk reduction by Take an active role in risk reduction participating in the architectural and during planning of renovations and new functional design of units and associated constructions in the healthcare essential services in the healthcare organisation organisation14

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